<style>
    table strong { color:#C00; }
    table td { padding: 4px 0; }
</style>
<?php 
    $model = $this->model;
?>

<table cellpadding="0" cellspacing="0" style="width: 550px;"> 
    <tbody>
        <tr>
            <td style="width: 25%;"><strong>Title:</strong></td>
            <td style="width: 30%;"><?php echo $model->prefix; ?></td>
            <td style="width: 20%;"><strong>Date Of Birth:</strong></td>
            <td style="width: 25%;"><?php echo $model->dob; ?></td>
        </tr>
        <tr>
            <td><strong>First Name:</strong></td>
            <td><?php echo $model->f_name; ?></td>
            <td><strong>Last Name:</strong></td>
            <td><?php echo $model->l_name; ?></td>
        </tr>
        <tr>
            <td colspan="4"><strong>Name As Appears On The Card:</strong> <?php echo $model->name_on_card; ?></td>
        </tr>
        <tr>
            <td><strong>Nationality:</strong></td>
            <td><?php echo $model->nationalityName; ?></td>
            <td><strong>Contact Email:</strong></td>
            <td><?php echo $model->p_email; ?></td>
        </tr>
        
        <tr>
            <td><strong>Personnal Email:</strong></td>
            <td><?php echo $model->alternative_email; ?></td>
            <td><strong>Mobile Phone:</strong></td>
            <td><?php echo $model->country_code.$model->phone; ?></td>
        </tr>
        <tr>
            <td><strong>Contact Address:</strong></td>
            <td><?php echo $model->address; ?></td>
            <td><strong>Country:</strong></td>
            <td><?php echo $model->countryName; ?></td>
        </tr>
        <tr>
            <td><strong>City:</strong></td>
            <td><?php echo $model->cityName; ?></td>
            <td><strong>District:</strong></td>
            <td><?php echo $model->districName; ?></td>
        </tr>
        
        
        <tr>
            <td colspan="4"><strong>Outlets where you would like to pick up the card:</strong> <?php echo $model->outlet; ?></td>
        </tr>
        <tr>
            <td><strong>Language Preference:</strong></td>
            <td><?php echo $model->lang; ?></td>
            <td><strong>Referer's Email:</strong></td>
            <td><?php echo $model->referer; ?></td>
        </tr>
        <tr>
            <td><strong>Referral Phone:</strong></td>
            <td colspan="3"><?php echo $model->referer_phone; ?></td>
        </tr>
        
    </tbody>
</table>
<?php 
    exit();
?>